Mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy

Abstract Background Surgery may render temporal lobe epilepsy (TLE) patients seizure-free. However, TLE is a heterogenous entity and surgical prognosis varies between patients. Network-based biomarkers have been shown to be altered in TLE patients and hold promise for classifying TLE subtypes and im...

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Autores principales:	Jacint Sala-Padro, Júlia Miró, Antoni Rodriguez-Fornells, Xavier Rifa-Ros, Gerard Plans, Mila Santurino, Mercè Falip, Estela Càmara
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Epilepsy Surgery Temporal lobe Biomarker Prognosis Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/706e09183b8a42659ef2076cb0dc0707
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spelling	oai:doaj.org-article:706e09183b8a42659ef2076cb0dc07072021-11-14T12:13:25ZMapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy10.1186/s12883-021-02469-11471-2377https://doaj.org/article/706e09183b8a42659ef2076cb0dc07072021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02469-1https://doaj.org/toc/1471-2377Abstract Background Surgery may render temporal lobe epilepsy (TLE) patients seizure-free. However, TLE is a heterogenous entity and surgical prognosis varies between patients. Network-based biomarkers have been shown to be altered in TLE patients and hold promise for classifying TLE subtypes and improving pre-surgical prognosis. The aim of the present study is to investigate a network-based biomarker, the weighted degree of connectivity (wDC), on an individual level, and its relation to TLE subtypes and surgical prognosis. Methods Thirty unilateral TLE patients undergoing the same surgical procedure (anterior temporal resection) and 18 healthy controls were included. All patients were followed-up in the same center for a mean time of 6.85 years and classified as seizure-free (SF) and non seizure-free (non-SF). Using pre-surgical resting state functional MRI, whole brain wDC values for patients and controls were calculated. Then, we divided both temporal lobes in three Regions-of-interest (ROIs) -mesial, pole and lateral- as these areas are known to behave differently in seizure onset and propagation, delimiting different TLE profiles. The wDC values for the defined ROIs of each individual patient were compared with the healthy group. Results After surgery, 14 TLE patients remained SF. As a group, patients had higher wDC than controls in both the temporal pole (p < 0.05) as well as in the mesial regions (p < 0.002) of the to-be-resected temporal lobe. When comparing between SF and non-SF patients, a step-wise binary logistic regression model including all the ROIs, showed that having an increased wDC of the temporal pole (p < 0.05) and the mesial area (p < 0.05) of the to-be-resected temporal lobe was associated with seizure freedom long-term after surgery. Conclusions This study provides a network-based presurgical biomarker that could pave the way towards personalized prediction. In patients with TLE undergoing anterior temporal resections, having an increased wDC at rest could be a signature of the epileptogenic area, and could help identifying those patients who would benefit most from surgery.Jacint Sala-PadroJúlia MiróAntoni Rodriguez-FornellsXavier Rifa-RosGerard PlansMila SanturinoMercè FalipEstela CàmaraBMCarticleEpilepsySurgeryTemporal lobeBiomarkerPrognosisNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Epilepsy Surgery Temporal lobe Biomarker Prognosis Neurology. Diseases of the nervous system RC346-429
spellingShingle	Epilepsy Surgery Temporal lobe Biomarker Prognosis Neurology. Diseases of the nervous system RC346-429 Jacint Sala-Padro Júlia Miró Antoni Rodriguez-Fornells Xavier Rifa-Ros Gerard Plans Mila Santurino Mercè Falip Estela Càmara Mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy
description	Abstract Background Surgery may render temporal lobe epilepsy (TLE) patients seizure-free. However, TLE is a heterogenous entity and surgical prognosis varies between patients. Network-based biomarkers have been shown to be altered in TLE patients and hold promise for classifying TLE subtypes and improving pre-surgical prognosis. The aim of the present study is to investigate a network-based biomarker, the weighted degree of connectivity (wDC), on an individual level, and its relation to TLE subtypes and surgical prognosis. Methods Thirty unilateral TLE patients undergoing the same surgical procedure (anterior temporal resection) and 18 healthy controls were included. All patients were followed-up in the same center for a mean time of 6.85 years and classified as seizure-free (SF) and non seizure-free (non-SF). Using pre-surgical resting state functional MRI, whole brain wDC values for patients and controls were calculated. Then, we divided both temporal lobes in three Regions-of-interest (ROIs) -mesial, pole and lateral- as these areas are known to behave differently in seizure onset and propagation, delimiting different TLE profiles. The wDC values for the defined ROIs of each individual patient were compared with the healthy group. Results After surgery, 14 TLE patients remained SF. As a group, patients had higher wDC than controls in both the temporal pole (p < 0.05) as well as in the mesial regions (p < 0.002) of the to-be-resected temporal lobe. When comparing between SF and non-SF patients, a step-wise binary logistic regression model including all the ROIs, showed that having an increased wDC of the temporal pole (p < 0.05) and the mesial area (p < 0.05) of the to-be-resected temporal lobe was associated with seizure freedom long-term after surgery. Conclusions This study provides a network-based presurgical biomarker that could pave the way towards personalized prediction. In patients with TLE undergoing anterior temporal resections, having an increased wDC at rest could be a signature of the epileptogenic area, and could help identifying those patients who would benefit most from surgery.
format	article
author	Jacint Sala-Padro Júlia Miró Antoni Rodriguez-Fornells Xavier Rifa-Ros Gerard Plans Mila Santurino Mercè Falip Estela Càmara
author_facet	Jacint Sala-Padro Júlia Miró Antoni Rodriguez-Fornells Xavier Rifa-Ros Gerard Plans Mila Santurino Mercè Falip Estela Càmara
author_sort	Jacint Sala-Padro
title	Mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy
title_short	Mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy
title_full	Mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy
title_fullStr	Mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy
title_full_unstemmed	Mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy
title_sort	mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy
publisher	BMC
publishDate	2021
url	https://doaj.org/article/706e09183b8a42659ef2076cb0dc0707
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Mapping connectivity fingerprints for presurgical evaluation of temporal lobe epilepsy

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